Individual provider Active NPI

Jonathan Charles Seccombe, M.D.

  • Gastroenterology Physician
  • Saint Louis, MO
National Provider Identifier
1124255849
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
2011037708 Issued in MO
Practice address
3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone
(314) 996-3520
NPI assigned
Jun 20, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 2011037708 MO Primary

Addresses

Primary practice location

3015 N Ballas Rd
Saint Louis, MO 63131-2329

Mailing address

3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-3520

Other practice location 1

121 Saint Luke's Center Drive, Suite 406
Chesterfield, MO 63017
Phone (314) 529-4900

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150721000711 MO Practitioner - Gastroenterology 6103047097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Emory University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Groups LCGroup PAC ID 3072421254, 526 clinicians

Practice addresses (Care Compare)

1110 Highlands Plaza Dr E
Saint Louis, MO 63110-1351
Phone (314) 273-0195

2630 Hwy K
O Fallon, MO 63368-6624
Phone (636) 240-5454

3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-5772

Hospital & facility affiliations

  • Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108
  • Barnes Jewish Hospital Hospital, Saint Louis, MO, CCN 260032
  • Parkland Health Center Hospital, Farmington, MO, CCN 260163

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy99
Upper gastrointestinal (GI) endoscopy for acid reflux202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Groups LC Gastroenterology CurrentSince Nov 1, 2023 Accepting new patients
Physician Groups LC CurrentSince Nov 1, 2023 Accepting new patients

Locations

2630 Highway K
O Fallon, MO 63368
Phone (636) 240-5454

3009 N Ballas Rd
Ste 359C
Saint Louis, MO 63131
Phone (314) 996-3520

3015 N Ballas Rd
Saint Louis, MO 63131
Phone (314) 996-5330

555 N New Ballas Rd
Ste 265
Saint Louis, MO 63141
Phone (314) 991-4644

3009 N Ballas Rd
Ste 210B
Saint Louis, MO 63131
Phone (314) 842-6333

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1124255849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 N BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312329",
            "telephone_number": "314-996-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 N BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312329",
            "telephone_number": "314-996-3520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "121 Saint Luke's Center Drive, Suite 406",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "MO",
            "postal_code": "63017",
            "country_code": "US",
            "telephone_number": "314-529-4900",
            "fax_number": "314-434-2679",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SECCOMBE",
        "first_name": "JONATHAN",
        "middle_name": "CHARLES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-20",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MO",
            "license": "2011037708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3015 N Ballas Rd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631312329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.